Girma Anteneh, H/Mariam Damen, Deribe Kebede
I-TECH Ethiopia, Semera, Afar.
Ethiop Med J. 2010 Jul;48(3):195-202.
Quality tuberculosis care plays an important role in the status of tuberculosis (TB) control, treatment completion and adherence. Nonetheless, very little is known about the quality of TB care in public health facilities in Ethiopia. In this study we assessed the quality of TB care delivery in Afar Region of Ethiopia.
A descriptive cross sectional health institution based survey with both semi-structured and structured questionnaires was employed. A mix of complementary techniques was administered Data were collected between 5th February and 10th March 2007 from six health institutions. Records were reviewed for 270 patients, exit interviews were made for 209 patients, six providers were interviewed & 49 patients were observed Data was collected by trained nurses and analyzed using SPSS 11.0 statistical software.
The study had showed that delivery of materials, drugs and supplies for tuberculosis control activities were fairly good. Staffing qualities were poor and patterns of supervision were weak. A relatively higher proportion of patients were dissatisfied with the appropriateness and adequacy of working hours (63.6%) and waiting time (70.3%). Statistically significant correlation was observed between process quality and output quality (clients' satisfaction) parameters (p < 0.001).
Continues quality improvement mechanisms to improve the different aspects of the programme and adherence to the National Tuberculosis and Leprosy Control Program guideline could be important interventions to enhance the quality of care delivery. An expanded community-based study to better guide quality DOTS program in pastoralist communities is crucial.
优质的结核病护理在结核病控制、治疗完成率和依从性方面发挥着重要作用。然而,对于埃塞俄比亚公共卫生机构中结核病护理的质量,人们了解甚少。在本研究中,我们评估了埃塞俄比亚阿法尔地区结核病护理的质量。
采用基于卫生机构的描述性横断面调查,使用半结构化和结构化问卷。运用了多种互补技术。2007年2月5日至3月10日期间,从六个卫生机构收集数据。对270名患者的记录进行了审查,对209名患者进行了出院访谈,对六名提供者进行了访谈,并观察了49名患者。数据由经过培训的护士收集,并使用SPSS 11.0统计软件进行分析。
研究表明,结核病控制活动的物资、药品和用品供应情况相当良好。人员配备质量较差,监督模式薄弱。相对较高比例的患者对工作时间的合理性和充足性(63.6%)以及等待时间(70.3%)不满意。在过程质量和产出质量(客户满意度)参数之间观察到统计学上的显著相关性(p < 0.001)。
持续的质量改进机制以改善该项目的不同方面并遵守国家结核病和麻风病控制项目指南,可能是提高护理质量的重要干预措施。开展一项扩大的基于社区的研究,以更好地指导牧民社区的优质直接观察短程治疗项目至关重要。